Kuznik Andreas, Bégo-Le-Bagousse Gaëlle, Eckert Laurent, Gadkari Abhijit, Simpson Eric, Graham Christopher N, Miles LaStella, Mastey Vera, Mahajan Puneet, Sullivan Sean D
Regeneron Pharmaceuticals, Inc., Tarrytown, NY, USA.
Sanofi, Chilly-Mazarin, France.
Dermatol Ther (Heidelb). 2017 Dec;7(4):493-505. doi: 10.1007/s13555-017-0201-6. Epub 2017 Sep 20.
Dupilumab significantly improves signs and symptoms of atopic dermatitis (AD), including pruritus, symptoms of anxiety and depression, and health-related quality of life versus placebo in adults with moderate-to-severe AD. Since the cost-effectiveness of dupilumab has not been evaluated, the objective of this analysis was to estimate a value-based price range in which dupilumab would be considered cost-effective compared with supportive care (SC) for treatment of moderate-to-severe AD in an adult population.
A health economic model was developed to evaluate from the US payer perspective the long-term costs and benefits of dupilumab treatment administered every other week (q2w). Dupilumab q2w was compared with SC; robustness of assumptions and results were tested using sensitivity and scenario analyses. Clinical data were derived from the dupilumab LIBERTY AD SOLO trials; healthcare use and cost data were from health insurance claims histories of adult patients with AD. The annual price of maintenance therapy with dupilumab to be considered cost-effective was estimated for decision thresholds of US$100,000 and $150,000 per quality-adjusted life-year (QALY) gained.
In the base case, the annual maintenance price for dupilumab therapy to be considered cost-effective would be $28,770 at a $100,000 per QALY gained threshold, and $39,940 at a $150,000 threshold. Results were generally robust to parameter variations in one-way and probabilistic sensitivity analyses.
Dupilumab q2w compared with SC is cost-effective for the treatment of moderate-to-severe AD in US adults at an annual price of maintenance therapy in the range of $29,000-$40,000 at the $100,000-$150,000 per QALY thresholds.
Sanofi and Regeneron Pharmaceuticals, Inc.
对于中度至重度特应性皮炎（AD）成人患者，与安慰剂相比，度普利尤单抗可显著改善特应性皮炎的体征和症状，包括瘙痒、焦虑和抑郁症状以及健康相关生活质量。由于度普利尤单抗的成本效益尚未得到评估，本分析的目的是估计一个基于价值的价格范围，在该范围内，与支持性护理（SC）相比，度普利尤单抗治疗中度至重度AD成人患者被认为具有成本效益。
建立了一个健康经济模型，从美国支付方的角度评估每两周（q2w）给药一次的度普利尤单抗治疗的长期成本和效益。将度普利尤单抗q2w与SC进行比较；使用敏感性分析和情景分析测试假设和结果的稳健性。临床数据来自度普利尤单抗LIBERTY AD SOLO试验；医疗保健使用和成本数据来自AD成年患者的健康保险理赔记录。针对每获得一个质量调整生命年（QALY）100,000美元和150,000美元的决策阈值，估计了被认为具有成本效益的度普利尤单抗维持治疗的年度价格。
在基础案例中，每获得一个QALY的阈值为100,000美元时，被认为具有成本效益的度普利尤单抗治疗的年度维持价格为28,770美元；阈值为150,000美元时，为39,940美元。在单向和概率敏感性分析中，结果通常对参数变化具有稳健性。
与SC相比，度普利尤单抗q2w治疗美国中度至重度AD成人患者具有成本效益，在每QALY阈值为100,000美元至150,000美元时，维持治疗的年度价格范围为29,000美元至40,000美元。
赛诺菲和再生元制药公司
